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<html lang="en" xmlns:th="http://www.thymeleaf.org">
	<head>
		<meta charset="utf-8">
		<title></title>
		<link rel="stylesheet" href="css/footer.css">
		<style>
			.css{
				margin-left: auto;
				margin-right: auto;
				max-width: 600px;
				background: #D2E9FF;
				padding: 20px 20px 20px 20px;
				font: 12px Arial, Helvetica, sans-serif;
				color: #666;
			}
			.css label>span{
				float: left;
				margin-top: 10px;
				color: #5E5E5E;	
			}
			.css label{
				display: block;
				margin: 0px 0px 5px;
			}
			.css label>span{
				float: left;
				width: 20%;
				text-align: right;
				padding-right: 15px;
				margin-top: 10px;
				font-weight: bold;
			}
			.css input[type="text"],.css textarea,.css select{
				color: #888;
				width: 70%;
				padding: 0px 0px 0px 0px;
				border: 1px solid #C5E2FF;
				background:#FBFBFB;
				outline: 0;
				-webkit-box-shadow:inset 0px 1px 6px #ECF3F5;
				box-shadow: inset 0px 1px 6px #ECF3F5;
				font: 200 12px/25px Arial, Helvetica, sans-serif;
				height: 30px;
				line-height: 15px;
				margin: 2px 6px 16px 0px;
			}
			.css button{
				padding: 10px 30px 10px 30px;
				background: #66CE14;
				border: none;
				color: #FFF;
			}
		</style>
	</head>
	<body>
		
		<form action="" method="post" class="css">
			<label>
				<span>处方医院：</span>
				<input id="name" type="text" name="name" placeholder="" />
			</label>
			
			<label>
				<span>患者姓名：</span>
				<input id="name" type="text" name="name" placeholder="" />
			</label>
			
			<label>
				<span>过敏史：</span>
				<input id="name" type="text" name="name" placeholder="" />
			</label>
			
			<label>
				<span>临床诊断：</span>
				<input id="name" type="text" name="name" placeholder="" />	
			</label>
			
			<label>
				<span>临床诊断：</span>
				<textarea id="name" type="text" name="name" placeholder="请输入病情描述" ></textarea>	
			</label>
			
			
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		<footer class="main-footer">
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	                <b>All rights reserved</b>
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	            <strong>Copyright &copy; 2021-11 
	                <a href="javascript:void(0)">信工研究院研发部</a>.
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